Category Archives: Health

New beginnings, new directions

Today is Rosh Hashanah which means that all of us Jews are celebrating the beginning of a new year. (5771? But I was just getting used to writing 5770! Har, har.) Today is also the day I begin my MA program in Health Communication at Emerson College (in partnership with Tufts University). And you can bet pretty soon, I’m going to be even more obsessed with health issues than I already am.

A lot of people ask me what health communication is and at this point I am starting to feel like I can give them a relatively accurate answer. Health communication is essentially communications tailored for the health field – more specifically, the study of creating and disseminating messages that will be effective in getting people to change their behavior – to quit smoking, wash their hands, eat more fruits and veggies, etc. I was attracted to this field because I already work and enjoy working in communications, and I wanted to mix that together with my interest in sexual health and healthy sexuality. Basically, I chose this program because I wanted to learn how to effectively communicate a few messages in particular, like “use a condom,” and “no seriously, just use a freaking condom!”

I’m pretty sure this program was a match made in heaven because I just got the syllabus for my first class and my first assignment is to pick an illness and analyze how it is perceived in our culture. I am so excited; that’s like my hobby. I’m pretty sure I’m already halfway through a video about just that. I know I’m a huge nerd, but I can’t wait to sit down and learn some theory and some skills to create effective health messaging and save the world, one sexually active teenager at a time. But, of course, I can already tell that it’s not going to be that simple.

Today a couple posts on Feministe caught my eye. The first is from former-Feministe blogger Zuzu, and is about fat and health, and succinctly states near the beginning: “Feminists typically agree that body policing is a bad bit of business, correct?” She then goes on to argue that being overweight does not necessarily mean someone is unhealthy, and that “There’s no Duty of Health”:

“Health” seems to be a codeword these days. It’s something to throw around when you get busted as a fat-hater: “I’m just concerned about your health!”

Well, let’s talk about health. First off, why is any individual obligated to be healthy in order to be accorded all the rights and dignity accorded to all human beings? What is this, “Starship Troopers,” with health substituted for military service? If you argue that fat people don’t “deserve” certain rights because in your judgment they aren’t “healthy,” then how do you feel about disabled people and their rights? If your argument is that the disabled can’t help it and fat is a choice, do you make the same argument for religious discrimination? Because religion is a choice, too.

The second is about slut-shaming, and hits on another feminist bulwark - “My body, my business.” And this ties closely into the pro-Choice “My body, my choice” philosophy too. The author illustrates this nicely:

Clearly, there is some conflict between the feminist approach to bodies and healthcare and the health communications goal of getting individuals to make healthier choices. It assumes that there is an objectively “healthier” choice, and also places the burden on the individual to be responsible for his or her own health. Zuzu wrote:

I’ve written about this before, and it ties into the whole good fattie/bad fattie defensiveness thing, but whenever we start focusing on the health of the individual, we erase the systemic problems that contribute to health issues. This is a perfect example of the personal being political.

Institutions love to shift the burden onto the individual, because it means the institution doesn’t have to examine its own behavior or its own contribution to a problem. Let’s look at bullying. States and schools love to have zero-tolerance policies so they can look like they’re being tough on bullying — but then when bullying incidents happen, they just don’t define it as bullying, and suggest that the victim change his or her behavior. Problem solved!

It’s really tricky.

The personal responsibility issue relates pretty directly to what we were discussing here earlier about safer sex, where I argued that the most effective way to prevent STD transmission was to emphasize personal responsibility in sex education and health messaging. But we do have to be careful not to ignore the social structures and institutions that make it difficult to make healthy choices, and perhaps the ethical route is to work towards changing those institutions and systems as well as changing individual behavior.

It’s also problematic to assume that we all agree on what “healthy choices” are. I am a believer in western medicine, but even doctors and scientists don’t always agree on what’s healthy. (Coffee? Having a glass of wine while pregnant? Hormone therapy?) So who am I to tell other people how to live their lives?

On the flip side, health is one of those things that as a society, we feel is important. And so there is some context for health messaging and health education being generally accepted as a positive thing. But there are ethical potholes to be wary of, and I’m definitely going to have them on my mind as I enter this program.

As we enter into this New Year, I plan to keep blogging on sexual health issues. I am excited to see how my new program will influence and inform my thoughts. I am also terrified to see how I will manage full time school and a full time job and my own health in the midst of the stress and chaos – and still find time to blog. It’s going to be a hell of a ride folks, I hope you come along with me.

Now, here’s a sex study that makes sense

After a dubious study from The Heritage Foundation nearly drove a friend of mine to insanity, it’s nice to see some conclusions based on actual research that account for and acknowledge socio-economic forces at work. In this study, researchers from the London School of Hygiene and Tropical Medicine (UK) analyzed data from 59 countries. They conclude that sexual health strategies must go beyond individual risk reduction and address social and economic determinants of behavior. (They also use funny spellings like “analyse” and “behaviour.”) (I’m allowed to make jokes because I lived there, ok? Sheesh.)

Here is the first part:

The analysis revealed the huge regional variation in sexual behaviour but also showed that there has been less change in behaviour over the past two decades than was thought:

  • There is no universal trend towards sex at a younger age. However, a shift towards later marriage in most countries has led to an increase in premarital sex, more so in developed countries and for men. Sexual activity in single people tends to be sporadic.
  • Most people are married (or live together in partnerships) and most sex happens in stable partnerships. Marriage does however not always safeguard sexual health.
  • Monogamy is the dominant pattern everywhere, but having had two or more sexual partners in the last year is more common for men and in industrialised countries.
  • Condom use has increased almost everywhere, but rates remain low in many developing countries.
  • School-based sex education improves awareness of risk and ways to reduce it. It increases the intention to practise safer sex and delays rather than hastens the onset of sexual activity.

So, contrary to certain bio-determinist beliefs, it seems as though we aren’t experiencing an “unprecedented rise in casual sex.” No universal trend towards sex at a younger age, either! Instead of looking at rates of “sex outside of wedlock” as evidence of moral decay, this study uses social logic to explain how premarital sex has increased while people aren’t having sex any younger: delay of marriage. And hey, they found that sex education actually “increases the intention to practise safer sex and delays rather than hastens the onset of sexual activity.” (We knew that, but it bears repeating!)

Regional variations in sexual behaviour do not correlate with sexual health status. Higher rates of partner change in industrialised countries are offset by higher levels of condom use and better access to treatment results in better health. The authors explored the main reasons for the variations:

  • Some of the variations can be explained by demographic and structural changes. The age structure and ratio of men to women in a population can limit or extend opportunities to form new partnerships.
  • There is a striking gender difference in sexual behaviour. Multiple partnerships are more common for men than for women. This is in line with a double standard in most societies that makes non-exclusive relationships more acceptable for men than for women.
  • Poverty, deprivation and unemployment work with gender inequity to promote partner change, multiple partners and unprotected sex.

Let’s talk about that “striking gender difference.” At first glance you might see this as support for the bio-determinist argument that men are just less monogamous and/or can’t keep it in their pants. But not so!  The authors make sure to first of all use the word “gender” and not “sex” to imply that this is not a XY/XX distinction, but a man/woman, “gender-as-a-social-construct” distinction. They point out, rightly so, that the data correlates with the double standard in most societies that makes non-exclusive relationships more acceptable for men than women (aka the “player” v. “slut” double standard). They also point to the influences of poverty, deprivation and unemployment on promoting partner change, multiple partners, and unprotected sex.

The authors highlight the need to base interventions on evidence rather than myths or moral stances. Approaches focusing exclusively on expectation of individual behaviour change are unlikely to produce substantial improvements in sexual health. Comprehensive multi-level behavioural interventions are needed that reflect the social context. These should attempt to modify social norms and tackle the structural factors that contribute to risky behaviour. Examples include mainstreaming HIV and sexual health in development projects; empowering sex workers through business and IT training; and integrating sexual health education into microfinance schemes. However, the success of these strategies requires decision-makers to accept the reality of sexual practices.

Wow.  I have shivers. Can we just read that again?

The authors highlight the need to base interventions on evidence rather than myths or moral stances. Damn straight!

Approaches focusing exclusively on expectation of individual behaviour change are unlikely to produce substantial improvements in sexual health. Comprehensive multi-level behavioural interventions are needed that reflect the social context. Amen!

These should attempt to modify social norms and tackle the structural factors that contribute to risky behaviour. Examples include mainstreaming HIV and sexual health in development projects; empowering sex workers through business and IT training; and integrating sexual health education into microfinance schemes. HELL YES!

However, the success of these strategies requires decision-makers to accept the reality of sexual practices. BAM.

And then, just when you thought this couldn’t get any better? They list and link to their sources and give an explanation of who funded the research. And guess what? It’s academic! Not a lobby group!

It’s work like this that gets me excited to begin my MA in Health Communications at Emerson next week. There is such a need for information about sexual health that serves not to moralize or control, but to actually reduce the spread of STDs based on the reality of sexual behavior and the social forces that influence it.

When encouraging personal responsibility is NOT blaming the victim

Nadja Benaissa, a German pop star, is currently on trial for infecting one man with HIV and putting two others at risk. She found out she had HIV in 1999 when she was 16. According to the charges, she had unprotected sex on five occasions between 2000 and 2004 with three men and did not tell them she was infected. One of them now has HIV. Benaissa is a member of the pop group No Angels, and before her arrest the fact that Benaissa was HIV positive was not publicly known. Even though Benaissa admitted that she made a mistake by having unprotected sex without disclosing her HIV status, some folks don’t think she’s the only one at fault.

Carolin Vierneisel, a representative from Deutsche AIDS-Hilfe, a German AIDS service organization, told Time Magazine: “When it comes to consensual sex, whether protected or unprotected, we talk about shared responsibility,” she says. “The criminalisation of HIV transmission, as shown in this case, doesn’t support HIV prevention efforts. On the contrary, it fosters the stigmatisation of HIV positive people.”

Katy Kelleher touches on this in her piece at Jezebel, and asks “Should Benaissa really be responsible when her partner consented to having unprotected sex?” She quotes Gisela Freidrichsen, a German journalist, who wrote: “I always wonder why there are allegations against a woman when a man doesn’t use a condom.”

For those of us familiar with feminism, rape crisis counseling, and Law and Order SVU, “blaming the victim” is bad, bad, bad. We always talk about blaming the victim in the context of rape and sexual assault. With sexual assault, there are victims and attackers, and the blame should always lie with attackers. But with STD transmission, there usually aren’t “attackers.” Except maybe in a few, extremely rare cases, people do not intentionally spread HIV in order to harm others. The majority of people who spread STDs aren’t aware they have one. For those that are aware they have an STD, they may fail to disclose their status for a number of reasons, not the least of which is shame resulting from social stigmatization of STDs. In Benaissa’s case, public disclosure could have had repercussions for her career as a pop singer. But even people like Benaissa, who did not take adequate steps to protect her partners, are themselves victims. They too were infected with HIV, possibly by someone who was similarly withholding that vital information.

With rape and sexual assault, victims (or survivors) are not in control of the situation. But when you’re talking about consensual sex, the onus usually falls on the individual to protect him or herself. Safer sex products, like condoms, are not that hard to get a hold of. A lot of people work very hard to make sure that condoms are available and affordable. Many health providers will give them out for free. I recognize that there is a bit of a gender imbalance here, since most condoms are “male” condoms and hetero women have a bit less control over whether their partner will wear one. But women can still buy and carry male condoms, use the female condom, and choose not to have unprotected sex — a decision everyone SHOULD be able to make and that all partners SHOULD respect.

One cannot really take precautions to keep one’s self safe from rape and sexual assault because assault can happen anywhere, at anytime, with anyone no matter what you are or aren’t wearing, how much you were or weren’t drinking, or whether you were or weren’t in a “safe” neighborhood. But one CAN take precautions to keep one’s self safe from STDs and since we can, we each shoulder the responsibility to protect ourselves.

This is not to say that those who knowingly transmit STDs are off the hook. I think most of us would agree that they are under a moral obligation to inform their partners before having unprotected sex. But should a moral obligation necessarily become a legal obligation? As far as I know, there is no criminal law in the U.S. or Germany that obligates one to inform all sexual partners of his or her HIV status. (If I’m wrong, please correct me.) Would the moral obligation still apply if they are using protection? Would a criminal law?

HIV and STD transmission turns victimhood on its head. When perpetrators are victims and the victims are in control of their own choices, we cannot be afraid to emphasize personal responsibility for fear of blaming the victim. It’s a lot easier for you to commit to using protection than it is for someone else to disclose their HIV status. Prosecuting those who fail to disclose will not do anything to help fight the spread of STDs, but encouraging personal responsibility sure will.

Why fear-based STD prevention PSAs are a bad idea

Recently, I started to pay attention to the sorts of messages being sent in STD prevention PSAs. I kept finding examples of ads that portrayed people with STDs as monsters or murderers, and with this video, I explain why this is not only cruel, but detrimental to health education goals.

This is my first video, so please be kind.

My Vision for a Feminist Crisis Pregnancy Center

Crisis pregnancy centers are increasingly relevant to our discussions of abortion access. These days, Pro-Life protesters find it more effective to hold signs saying, “Need Help? Come to our Crisis Pregnancy Center,” instead of “DIE YOU BABY KILLER.” (Good call, Pro-Lifers.) The problem with the Pro-Life offer of “help” is that these so-called Crisis Pregnancy Centers are not really what they appear to be.

While many claim to offer psychological counseling services, they rarely have medical professionals on staff. They use the rhetoric of choice (words like “options” and “choices”) but exist to convince vulnerable women to continue their unplanned, and often unwanted, pregnancies. They are happy to downplay the hard realities and difficulties of parenthood, adoption, and carrying a pregnancy to term. They are also happy to give out misinformation, like that abortion causes breast cancer (it doesn’t) or post traumatic stress disorder and other mental health issues (it doesn’t). As Emily Kadar wrote, “Women and girls visit CPCs at the beginning of an unplanned pregnancy, one of the most vulnerable states in which one could be, and they are given false information and limited choices. And it angers me.”

So, I was excited to see a post on Feministing asking the question “What would a feminist crisis pregnancy center look like?” The author shared one vision, which you should take a second to check out. Back? Okay.

I agree and love many of the points the author makes. A feminist Crisis Pregnancy Center should be Pro-Choice, should provide education about pre-natal healthcare and birthing options, parenting classes, free counseling from licensed professionals, and financial assistance to parents-to-be. Absolutely.  But what seemed to be missing from this picture was help for women who choose abortion as well.  So, here is my vision for a feminist Crisis Pregnancy Center.

  1. It would offer counseling and information for women seeking help making their choice. It would provide non-judgmental information about abortion, adoption, and parenthood and help each woman decide what was best for her and her situation.
  2. It would provide referral services to abortion providers, adoption agencies, healthcare providers, and other organizations supporting women who choose to parent. It would screen the organizations and providers to make sure that women are referred to reputable, and like-mindedly feminist “safe spaces.”
  3. It would provide free (or on a sliding scale), ongoing counseling for women – no matter what their choice – before, during, and after the unplanned pregnancy/abortion/adoption/birth.
  4. It would incorporate financial and material assistance to women who need help paying for an abortion, paying medical bills, and starting out as new parents. It could work together with abortion funds, help collect donated baby supplies, etc.
  5. It would provide parenting classes.
  6. It would provide free comprehensive safer sex education and counseling, covering contraception options as well as STI prevention and safety for anyone seeking information or help.
  7. It would provide free education and counseling on sexual assault and relationship violence, including referrals to domestic violence resources, etc.

Feministing asks what your visions are, and what it would take to make this happen. I can’t help but wonder: Why hasn’t this happened?

New organizations are set up all the time. Why don’t we have feminist crisis pregnancy centers? Why not? Seriously people, wouldn’t it be amazing to have a place you could go to get real information and real help from people who do not have an agenda and will support you in whatever choice you make?

What would it take to make this happen? And when can we start?

“EC is not the abortion pill”: a Rhetoric Fail for ellaOne

As a sex educator and counselor, I have given the emergency contraception (EC) spiel many times. There are two important points that must be made. The first is to explain that “the morning after pill,” is a misnomer because EC it works for up to 72 hours after unprotected sex. The second is to make absolutely sure that everyone understands that EC is NOT! THE! ABORTION! PILL!

Differentiating between Plan B (EC) and RU-486 (the abortion pill) was a key component of the strategy to make Plan B available without a prescription, to convince pro-life pharmacists to dispense it, and to reassure women that taking Plan B will prevent pregnancy without terminating or harming an embryo if pregnancy has already occurred. This strategy was effective, and necessary, and is often used to promote EC as the solution to “the abortion problem.”  If everyone had access to EC, women wouldn’t need to have so many abortions, and we can all agree that abortions are the least desirable outcome. Unifying as this strategy can often be, it is problematic.

A form of EC already used in 21 European countries called “ellaOne” is headed to the FDA for U.S. approval and is generating a great deal of controversy. EllaOne works differently than Plan B, and can prevent pregnancy for up to five days. FIVE DAYS.  Like Plan B, ellaOne is more effective the earlier it’s taken, but studies seem to be showing it is still more effective than Plan B.  This is a big deal.

Folks don’t realize that time can be a major barrier to obtaining Plan B, especially for those who live in rural areas, or anywhere that doesn’t have 24 hour pharmacies or Choice-friendly clinics or pharmacists.  Sometimes it can take a day or two to figure out where to get Plan B and negotiate how to get there and how to get the time off from work. The cost of Plan B (around $50) is also a barrier, and it may take a few days to scrape together the money to pay for the pill.  An extra 2 days of effective prevention could make ellaOne a real game-changer.

The problem is that ellaOne may have some chemical similarities to RU-486, the abortion pill.  According to the Washington Post, it is possible that ellaOne could induce an abortion by making the womb inhospitable to an embryo. (Much like what happens during a miscarriage.) But ellaOne (ulipristal acetate) is NOT the same as RU-486 (mifepristone). The differences are explained in this fact sheet.

Regardless, the Pro-Life lobby is well on its way to preventing ellaOne from being approved by the FDA. As Ms. Magazine reminds us, the Pro-Life lobby prevented the FDA from approving Plan B until 1998, when it had already been used in Europe since the 1970s. It took another 8 years of fighting to make Plan B available over the counter for women 18 and up. Plan B was only made available over the counter to 17 year olds in 2009. Getting ellaOne approved by the FDA will be a political battle rather than a medical one. And unfortunately, we have already sabotaged our case with our own anti-abortion rhetoric surrounding EC.

By driving home the distinction between EC and the abortion pill and stressing that EC is acceptable because of this distinction, we have set up ellaOne to fail. If ellaOne does cause “abortions” (or miscarriages, or “spontaneous abortions” just like ones that occur naturally), well, we’re screwed. We played the game of rhetoric, and now we might have to put our foot in our mouths.

I keep putting “abortions” in quotations because it’s important to acknowledge that no one is really sure if ellaOne causes abortion. The reason is not because we don’t understand what the drug does – we do – it’s that there is no consensus on when life begins, so it’s pretty hard to define what is and what isn’t an abortion when we’re talking about fertilized eggs and uterine implantation.  Does life begin with a fertilized egg? Does it begin when that egg implants on the uterine wall?  Does an egg that naturally fails to implant an abortion? A miscarriage? Or just another period? It’s confusing, but the Pro-Life lobby is happy to spin it. By claiming that ellaOne has similarities to the abortion pill, it will be viewed as an abortion pill. And by demonizing the abortion pill as the pro-EC rhetorical strategy has done, we have hurt the case for ellaOne.

In most cases, the people promoting EC are Pro-Choice and actually support RU-486.  From a Pro-Choice, pro-healthcare-access point of view, RU-486 is a good thing. It is a great option and has the potential to make abortion safer and more accessible for many women. It has even been administered via webcam to women in remote locations!

And ellaOne, even if it does sort of cause “abortions,” would be a great product to fill that in-between space – the space between Plan B and abortion. For those truly concerned with reducing the demand for abortion – real, unambiguous abortion – ellaOne is actually a good thing. A really good thing.

Let’s hope that it doesn’t take another 30 years to give American women better control over their own health, bodies, and lives.

Is it time for routine HIV testing?

A recent study says that many HIV positive patients in the US and Canada are getting diagnosed too late for modern treatments to be fully effective. The US News writes:

The public health implications of our findings are clear,” study author Dr. Richard Moore, from the Johns Hopkins University School of Medicine in Baltimore, said in a news release. “Delayed diagnosis reduces survival, and individuals enter into HIV care with lower CD4 counts than the guidelines for [initiating] antiretroviral therapy.” A delay in getting treatment not only increases the chance that the disease will progress, but boosts the risk of transmission, he added.

This study has got me thinking about routine HIV testing, a subject I mulled over quite often while writing my undergrad senior thesis on HIV/AIDS public health policy. The CDC recommended routine HIV testing for all Americans in 2006, but because of the complicated history of the AIDS epidemic and resulting HIV public health policy in the U.S. we are still hesitant to take that step. Here’s some background.

Historically, public health existed in order to protect the public from the sick. Traditionally, Americans have understood that in the case of certain easily transmitted diseases, the health and safety of the general public outweigh an infected person’s individual rights. Authoritarian strategies like mandatory testing, name reporting, contact tracing, and even quarantine are old hat for many STIs and other communicable diseases like TB. There’s a reason the CDC is called the Center for Disease Control; they don’t mess around.

In reality, most of us do not experience these more extreme measures of control in our daily lives. Most of the time, you don’t need to pass a syphilis test to obtain a marriage license and hospitals and clinics often offer confidential or anonymous STI testing. Still, a virulent strain of TB can get you landed in quarantine.

The only communicable disease that is legally protected from these types of authoritarian public health controls is HIV/AIDS. Instead of existing to protect the public from the infected at any cost, HIV/AIDS public health law is designed to protect the infected from discrimination. This is largely due to it’s unique history as a disease that suddenly appeared in the 1980s and decimated an already marginalized and stigmatized group (gay men).

A tactic such as mandatory testing would have been a huge threat to the gay community, since at that time being HIV positive was an indicator that one was gay, and it was not quite as safe to be “out” as a gay man in the 1980s. (Not that it is always safe now, but I would argue that general tolerance and acceptance has dramatically improved.) But even beyond the gay issue, people were scared of HIV/AIDS because so much about it was yet unknown. Most did not understand how it was transmitted, and were afraid to come in contact with those who had it. They did not want them in their offices, working in restaurants, or going to school with their children. Hello, discrimination. There is also a lot more to it than that, including the aversion to sick people thanks to the idea that morality and illness are somehow connected (check out Susan Sontag’s Illness as Metaphor). But I digress…

Thanks to the efforts of gay rights leaders, activists and politicians of the 1980s, mandatory HIV testing is illegal, confidentiality of one’s HIV status is paramount, and public health officials cannot separate folks with HIV from the rest of society in any way. This was groundbreaking legislation and policy, and at the time completely necessary. But is it still necessary?

In the late 1990s and early 2000s, the strong emphasis on confidentiality and individual rights began to relax. This was perhaps natural as the fury of the AIDS epidemic of the 1980s began to die down as well. Still, some important changes began to occur. First, a new drug that was effective in reducing the transmission from mother to newborn led the CDC and others to endorse HIV screening for pregnant women, and many states began doing so. And the measures were pretty effective in helping reduce the rates HIV transmission to infants.

In an article called “Applying Public Health Principles to the HIV Epidemic.” from the New England Journal of Medicine (2005), Thomas Friedman, the then Health Commissioner of New York, wrote:

Although stigma and discrimination on the basis of sexual orientation continue, advocacy has resulted in substantial progress, including antidiscrimination statutes in many states and increasing numbers of jurisdictions that recognize the rights of domestic partners. The world has changed in the past 25 years, and approaches to HIV prevention must also change.

That article recommended a switch to routine HIV testing in addition to a re-commitment to prevention methods, such as condoms, sex education, and needle exchange programs. Routine testing would mean that your yearly physical would also include an HIV test. You would of course be able to opt out, but the idea is that it would be treated as a common, routine, health practice.

By 2005, the CDC was recommending routine testing for high-risk groups and individuals. In 2006, the CDC issued a recommendation for the very first time that we begin routine HIV testing for all Americans. Considering the history of HIV public health policy, that was kindof a big deal. But as you can see, it didn’t really happen.

HIV testing is still a completely voluntary thing, and while some of us are good about getting tested regularly, most Americans get tested once or twice in their lives, or not at all. And this is part of the problem identified by this new study. Is routine testing the solution to this problem?

Routine testing would help those diagnosed receive treatment early enough to be most effective. It could also help prevent unknowing transmission. There is a chance it could even help reduce stigma through normalization. But are we ready?

What do you think?

If you are by any chance a public health nerd and would like to read my undergrad senior thesis: “Is AIDS Special? A New Paradigm of Public Health and Individual Rights,” you can download it here. I warn you, it’s long. Just don’t plagiarize me, bro.

VivaGel isn’t a cure, but it might reduce transmission and stigma

Today Starpharma Holdings Ltd. announced that a new “herpes-killing” gel, VivaGel, might be ready to go on sale by 2012. This is great news, but unfortunately calling it a “herpes-killing gel” is misleading. VivaGel is microbicide designed to stop herpes from spreading from partner to partner. It is NOT a cure for herpes. If you already have herpes, VivaGel will not “kill” it, but rather help protect your sexual partners (the ones with vaginas, anyway) from contracting it. Starpharma Holdings Ltd. is also looking into whether or not the gel will be effective for preventing the spread of HIV.

It seems like this would be a great product for those who already have herpes and their partners. But would it really be effective in reducing the spread of herpes in general? I doubt it. For those more casual encounters, women are not likely to carry around VivaGel in addition to condoms just in case the person they hook up with might have herpes. For one, no one goes into a hook-up thinking their partner might have herpes. Secondly, it would be pretty awkward to try to introduce the gel to your partner without offending them, scaring them, or at the very least, ruining the mood. The reality is that no one will be likely to use the gel unless they are having sex with someone they know to have herpes, with whom they are comfortable enough to talk about the issue. This would most likely apply to people in on-going relationships – those who are (hopefully) already being careful regarding transmission.

The really interesting implication here is that a product like VivaGel might help folks feel more open to dating persons with herpes or other STIs. Having an STI makes dating a challenge, and many folks turn to online dating sites where they can meet others who also have STIs. Social stigma can be blamed for much of the aversion to dating someone with an STI, but part of that aversion is fear due to the real risk of contracting the STI. If VivaGel reduced that risk, it could also reduce social stigma and help us work towards a society in which folks with herpes and other STIs aren’t thought of like lepers, where we are comfortable enough to be honest about our STI status with our partners, and where dating sites aren’t segregated between the “clean” and “infected.”

Doing my part for global health

I recently discovered the Fully Sick Rapper through Facebook. and have developed a huge internet crush on him! Christiaan VanVuuren, aka the “Fully Sick Rapper,” is an Ozzie who had contracted Tuberculosis (TB) on a trip to South America. He has been in quarantine for months, and maintains his sanity (or lack thereof) by creating hilarious rap videos about his life in quarantine and sharing them on Youtube. I put one on while I was checking email this morning, and realized that – wait a second – I should be taking my weekly malaria pill!

I’m leaving for a trip to Belize (in Central America) on Wednesday. A couple weeks ago, I was looking up travel tips on WikiTravel. I found a note about checking the CDC’s Travelers’ Health website, where I found information about Belize by click on “Destinations.” That’s how I learned that there is a risk of contracting malaria in that area, and that preventative antimalarial drugs are recommended.

We have heard a lot lately about pandemics thanks to H1N1. Despite the fact that most people consider the H1N1 scare an “overreaction,” flus and other viral communicable diseases like TB are a big fucking deal, especially when drug-resistant strains develop and spread to countries unequipped to treat them. It’s also important to realize that other diseases, like STIs can also be passed around through international travel. Randy Shilts, author of And the Band Played On, theorizes that HIV came to the United States in 1976 during the national bicentennial celebration. To celebrate the country’s 200th birthday, New York harbor was crammed with Navy ships that had been all over the world, and a whole heck of a lot of world-traveled sailors partied hard in the same city. Four years later, gay men began to show symptoms of what we now understand to be AIDS.

The World Health Organization and plenty of NGOs work hard to prevent the international spread of disease, especially of communicable disease like TB, H1N1, avian flu, etc. But some responsibility lies on the part of the individual. Now that we live in such a global society, where people can hop planes and cross oceans in a matter of hours, we are each responsible for protecting ourselves and others when we travel. For me, this meant doing a little research and getting a prescription for anti-malarial drugs before my trip. It also means remembering to TAKE the pills, which I almost forgot until the Fully Sick Rapper reminded me.  So, next time you travel, do your part to prevent the spread of disease and follow these steps:

  1. Research the country you are traveling to for information about health risks, vaccines, and other preventative health care. I think the CDC Travelers’ Health page is great for this.
  2. Follow up.  Get your immunizations and fill your prescriptions.
  3. Comply with preventative treatment. (Don’t forget to take your pills!)
  4. Comply with treatment if you do get sick. (Don’t be like that guy who found out he had TB and had to be forcibly quarantined after he hopped a plane to Europe and put hundreds of people at risk.)
  5. Bring condoms. This rule may not apply to everyone, but it definitely applies to anyone who hopes meet someone on their trip. It also applies to anyone staying in youth hostels because even if you aren’t going to need them, someone you meet in the hostel probably will.

Thanks for listening to this long-winded public service announcement. Safe travels!

The least-gross menstrual product on the market

The Mooncup Ltd’s “Love Your Vagina” campaign — in which women share their pet names for their vagooches, va-jay-jays, and vajimuffins — is getting a lot of attention recently.  Amy Winehouse’s has even joined in, revealing that she calls her vagina her “Va-Jew-Jew.” While I obviously support vagina-love, this campaign feels tired to me. (Or have I just been in the vagina-positive bubble for too long?) Either way, I just call mine “my vagina.”

What is interesting about this campaign, to me, is the product (and marketing campaign) behind it.  The Mooncup is an alternative menstrual product, aka, an alternative to pads and tampons. I have been a huge advocate for the Mooncup (UK company), the Diva Cup, the Keeper, and the other Mooncup (US Company), for years and it is exciting to see one of these products begin to bridge the mainstream “lady” market. The unfortunate reality is that most people fear these products because they are unfamiliar, and because in order to use them, one has to get a little more familiar with one’s own vagina.

In reporting the breaking story of Amy Winehouse’s va-jew-jew, Heeb writer “StevenM” called the Mooncup, “possibly the grossest feminine hygiene product ever created.”  This statement is absolutely, positively, supercalifragilisticexpialidociously WRONG, and I’m not sure why “StevenM” thinks he is in the position to offer judgement of the “grossness” of menstrual products.  If you would like to know about the Mooncup, Diva Cup, or the Keeper, try listening to testimonials from women who actually use them. Like me.

I use the Keeper, which is essentially the same thing as the Mooncup except it is made out of all-natural gum rubber instead of silicone. I have been using mine for almost 6 years now (they last about 10), which means I haven’t spent money on menstrual products in 6 years. It is a reusable cup that you place inside your vagina, where it collects menses during your period. (I know it looks big, but you fold it in half when you insert it.) Once or twice a day, depending on your flow, you empty it out in the toilet or shower and put it back in.  When your cycle is done, wash with soap and water and store it in a cloth bag. Is that really so scary?

I’m not one to use my blog to endorse products, but I see this as much more than that. First of all, I am not getting paid to write this, nor was I asked to by Mooncup Ltd. or any other company. I am writing this because these products offer a lot of benefits that enable and empower women to save money, be green, be active, be discrete, and be less gross while they have their periods. The Mooncup is not just another “feminine hygeine” product preying on women’s insecurities; it is a step towards liberation.

Here’s why.

  1. It’s safer. Unlike tampons, menstrual cups carry no risk of Toxic Shock Syndrome (TSS). This means you can leave it in for as long as you want, and only worry about it once a day or once every two days. You can even wear it when you’re not having your period. Also, the Mooncup and Diva cup are made of medical-grade silicone and do not have the bleach, scents, or other chemicals found in tampons and pads.
  2. It’s economical. Keepers and Mooncups generally cost between 20 and 35 dollars and they last for 10 YEARS. You save literally hundreds of dollars on menstrual products each year by switching.
  3. It’s green. Menstrual cups do not generate waste, whereas  tampons and pads create waste from packaging, applicators, and don’t forget the yucky used products.
  4. It’s discrete. With a menstrual cup, you will never have to awkwardly bring your purse to the bathroom with you again. Not only that, you wont have to leave a wadded up surprise in your friend’s bathroom trashcan – or risk clogging their toilet with your used tampon.
  5. You won’t be caught without a tampon. Since you can put your menstrual cup in ahead of time, you will already be wearing it when your period comes! This is perfect for camping, travelling, and all those other times when you don’t know when you’ll next have access to a bathroom.
  6. It’s comfortable. You can barely feel it in there. You will probably forget you even have your period. Also, you can say goodbye to that awful feeling of shoving dry cotton into your vagina.
  7. It doesn’t dry you out. Tampons absorb menstrual fluid and everything else, sometimes leaving you dry and uncomfortable inside.  Menstrual cups do not; they fit over the cervix where they collect menses, but the rest of your vagina is free to go about business as usual. This means that the regular, non-period fluids act just the same as always.
  8. It’s clean. When people make the “gross” argument, I would take a moment to remind them how gross using tampons can be. (How many of you have gotten blood on the toilet seat or your hands?) Menstrual cups are much cleaner than that. The menses are contained INSIDE the cup, so the part you touch (the outside) is clean! Also, since the menses are contained within the cup – which works by creating an air-tight seal against your cervix – your vagina stays clean! So clean, in fact, that you could receive oral sex while you’re on your period.  Yep. Believe it.

It’s important to realize why folks react to the idea of the menstrual cup the way they do. It’s because we are conditioned to think that it’s gross to touch our own vaginas, and to use a menstrual cup, you have to touch your own vagina. And unfortunately, that stigma is holding many women back from experiencing the physical and financial liberation offered by these products.

Mooncup Ltd. is right to recognize that their product actually is a way to “Love your vagina.” Let’s drown out the “ew, gross!” reactions with a loud chorus of vagina-loving voices.